An apicoectomy, sometimes called root end surgery, is a microsurgical procedure that saves a tooth when infection persists at the tip of its root despite root canal treatment. At Williamsburg Endodontics in Brooklyn, our endodontists perform apicoectomies using operating microscopes and ultrasonic instruments, a combination that has transformed this procedure into a precise, predictable, and comfortable treatment.

Here is the situation an apicoectomy solves. After a root canal or retreatment, a small number of teeth continue to harbor infection in the tissue surrounding the very tip of the root, an area called the apex. Sometimes the root tip contains microscopic branches that cannot be cleaned from inside the tooth. Sometimes a cyst or persistent inflammation develops in the bone around the apex. When treating the canal from above has been exhausted, treating the root tip directly from the side becomes the answer.

During the procedure, we make a small opening in the gum near the affected tooth to access the root tip. We remove the infected tissue along with the last few millimeters of the root apex, then place a small biocompatible filling to seal the end of the canal. A few tiny sutures close the gum, and over the following months the bone naturally heals around the treated root.

What can you expect during an apicoectomy at our Williamsburg office?

The word surgery makes many patients nervous, so let us set expectations honestly. An apicoectomy at our Hope Street office is performed under local anesthesia, takes roughly 30 to 90 minutes depending on the tooth, and most patients are back to their normal routine the next day. The microscope allows us to work through a very small access point, which means less swelling and a faster recovery than the surgical procedures of a generation ago.

Mild swelling and soreness for a few days is the typical experience, managed with cold compresses and over the counter pain relief. We remove sutures at a brief follow up visit, and we monitor the healing bone with imaging at subsequent checkups. Our Brooklyn team gives you clear written aftercare instructions and remains available if anything feels off.

It is worth knowing that an apicoectomy is a tooth saving procedure of last resort in the best sense: it exists precisely so that a stubborn infection does not force the extraction of an otherwise healthy, functional tooth.